Tuberculous bladder contraction

　　The causes and pathological changes of bladder contraction arise from the repeated invasion of tuberculosis bacteria coming from renal tuberculosis, causing severe tuberculous cystitis. In the mucosal and muscular layer of the bladder, there is congestion, edema, tuberculous nodules, tuberculous ulcers, and granulomas. There is a large infiltration of lymphocytes and the formation of fibrous tissue, eventually leading to bladder contraction. After the contraction of the bladder, the bladder wall loses its normal elasticity, and the capacity is significantly reduced. It is generally believed that the capacity of the contracted bladder is5Below 0ml. In severe cases, the bladder can shrink to several milliliters in capacity. Since the bladder is repeatedly infected by tuberculosis bacteria, the pathological changes within the bladder are a concurrent process of acute and chronic, inflammation and fibrosis.

　　1Urinary system infection:Due to the shrinkage of the bladder after contraction and frequent urination, it is easy to cause pathogenic organisms to invade the ureters and bladder via the urethra, causing urinary system infection.

　　2Hematuria:The kidneys, ureters, and bladder undergo mucosal damage under the repeated stimulation of tuberculosis bacteria, leading to hematuria due to the rupture of capillaries.

　　3and renal failure:Patients with bladder contracture usually have ureteral contracture, so renal function failure may occur due to obstruction of renal excretion function.

　　1and significant frequency of urination, with very little urine output each time, severe cases may have urinary incontinence; often accompanied by dysuria, pyuria, hematuria, etc.

　　2and palpable mass in the upper abdomen when there is contralateral hydronephrosis.

　　3and may develop chronic renal insufficiency symptoms in severe cases.

　　Comprehensively popularize knowledge of infectious diseases, do a good job in the prevention of infectious diseases, and actively treat systemic tuberculosis. The treatment of tuberculosis must be standardized to avoid recurrence and induce the disease. The treatment process should follow the principles of early, full, combined, appropriate, and standardized to avoid missed doses causing drug resistance, and the treatment course is usually6-9months, so confidence and patience are required, and the prognosis is good with regular treatment.

　　Strengthen nutrition, unless azotemia, high-protein diet can be consumed. The patient's diet should be light, easy to digest, with more fruits and vegetables, a reasonable diet, and attention to adequate nutrition. In addition, patients should avoid spicy, greasy, and cold foods.

　　The treatment of bladder contracture due to tuberculosis often requires surgery. If there is no urethral stricture and the condition allows, a sigmoid colo-vesical augmentation should be performed, which has been shown to be effective in long-term follow-up. If there is a urethral stricture, a urinary diversion surgery should be chosen. If due to severe illness, the patient cannot tolerate major surgery, a permanent nephrostomy or ureterostomy can be performed. In any case, oral anti-tuberculosis drugs must be combined, which is an essential and very important treatment method.